Provider Demographics
NPI:1053577262
Name:DINGIANNI, JAMIE (ITDS)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:DINGIANNI
Suffix:
Gender:F
Credentials:ITDS
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:412 TORTOISE TRACE
Mailing Address - Street 2:
Mailing Address - City:ST JOHNS
Mailing Address - State:FL
Mailing Address - Zip Code:32259
Mailing Address - Country:US
Mailing Address - Phone:904-910-3847
Mailing Address - Fax:904-230-2219
Practice Address - Street 1:412 TORTOISE TRCE
Practice Address - Street 2:
Practice Address - City:SAINT JOHNS
Practice Address - State:FL
Practice Address - Zip Code:32259-5458
Practice Address - Country:US
Practice Address - Phone:904-910-3847
Practice Address - Fax:904-230-2219
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-07
Last Update Date:2010-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist